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The IAAF has published new rules for female athletes with high natural testosterone levels which could force two-time Olympic 800-meter champion Caster Semenya to stop running middle-distance races.

From November 1, the IAAF will limit entry for all international events from 400 meters through the mile to women with testosterone levels below a specified level.

Women with elevated testosterone must reduce their level for "six months (e.g., by use of hormonal contraceptives)" before being eligible to run, and maintain that lowered level.

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IAAF president Sebastian Coe says track's governing body must "ensure a level playing field where success is determined by talent, dedication and hard work rather than other contributing factors."

"We want athletes to be incentivised to make the huge commitment and sacrifice required to excel in the sport, and to inspire new generations to join the sport and aspire to the same excellence," he said.

Semenya now faces taking daily medication or start racing for South Africa at 5,000 meters.

Caster Semenya's career has been glittering, but has always attracted controversy.(AAP: Tracey Nearmy)

Athletics authorities have struggled to find a solution to the issue that respected the rights of Semenya while also providing what they says is a "level playing field".

Other athletes believe she has an unfair advantage because of the high levels of naturally occurring testosterone in her body. But, under the new rules Semenya will either have to take prescribed medication to compete at her event or move to longer-distance running.